Why is it important to talk about falls?
The CDC estimates in 2014 there were 29 million older Americans that suffered a fall. Of these, 7 million resulted in injuries (1). The medical costs associated with providing the necessary medical care after injurious falls is rising as our population ages. In 2012, $30.3 billion were spent in the treatment of injuries from falls. This number rose by 1 billion by 2015 (2). In addition to the cost associated with falls, quality of life can be impacted.
After suffering a fall, people tend to report a higher fear of falling that can result in decreased participation and quality of life. Furthermore, fear of falling is associated with an increase in fall risk, thus creating a potential cycle of repeated falls. This information might make you wonder why it is that as we age we have greater difficulties with balance.
So, why does the risk of falling increase as we age?
As we age, our muscle mass and muscle power decrease. This can contribute to greater difficulty with activities such as getting up from chairs, going up and down stairs, and walking longer distances (3). Other systems in our body that experience changes as we age include our vision, sensory, and vestibular systems. This results in greater difficulty focusing on objects, getting feedback from our feet and legs, and understanding our spatial orientation, respectively. The impact of these changes in our functional mobility has been associated with an increase in fear of falling (3).
Our ability to maintain our balance regardless of the type of surface we are standing on or the activity we are doing is a result of our brain integrating information it receives from our vision, sensory, and vestibular systems. The brain then processes this information and creates a motor response that allows us to maintain our balance. That is, it creates the necessary muscle contractions to keep us upright. Thus, it is understandable that as these systems naturally become less accurate, it becomes harder to hold our balance. In addition, medical conditions such as diabetes, cerebrovascular accidents (strokes), heart disease, and Parkinson’s disease can all have different effects on our bodies that further contribute to changes in equilibrium. However, researchers have helped us better understand what each of us can do at home to decrease the odds of having a fall and allow us to continue to participate in the activities we enjoy.
Is this preventable?
According to data from the National Council on Aging (NCOA), 75 percent of falls happen inside the home. In an effort to raise awareness about the importance of preventing falls, the NCOA instituted an annual Falls Prevention Awareness Day (FPAD). Since its start 10 year ago, 48 states and D.C. have joined in the observance of this day by helping create informational brochures and share resources with the community. You can access www.ncoa.org for a list of resources. Here are a few steps to get you and your family started at home!
5 Ways to Make Your Home Safer
1. Install rails on both sides of the stairs.
2. Make sure all areas are well lit.
3. Remove area rugs were possible. Consider rubber backed rugs in areas were rugs are a must.
4. Place strips of colorful tape at the edges of steps or over thresholds to make it easier to differentiate them from the rest of the floor.
5. Remove clutter and try to keep a clear path in areas that you tend to move around the most.
In addition to safety proofing your home, participating in a fall risk prevention program or in physical therapy have been shown to improve mobility and balance responses. These kinds of programs can help you feel more comfortable when performing your daily routine and decrease your risk of injury from a fall. Search for programs in your community or contact a physical therapist in your area to be evaluated and get set on your path to staying on your feet.
This blog post was provided by Ana Sanchez Junkin, PT, DPT, NCS. She is a board-certified neurologic clinical specialist and a physical therapist at Emerson Hospital’s Clough Family Center for Rehabilitative and Sports Therapies. To learn more, call 978-287-8200 or visit www.emersonhospital.org/rehab.
Bibliography
1. www.cdc.gov/media/releases/2016/p0922-older-adult-falls.html
2. Burns, ER; Stevens, JA. The direct costs of fatal and non-fatal falls among older adults – United States. September, 2016. Journal of Safety Research
3. Trombetti, A; Reif, KF; et al. Age-associated declines in muscle mass, strength, power, and physical performance: impact on fear of falling and quality of life. February, 2016. Osteoporosis International